1801042833 NPI number — BYOUNG K. LEE, MDPA

Table of content: (NPI 1801042833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801042833 NPI number — BYOUNG K. LEE, MDPA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BYOUNG K. LEE, MDPA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801042833
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13000 GEORGIA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20906-5330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-942-2676
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13000 GEORGIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20906-5330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-942-6003
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KIM
Authorized Official First Name:
CLARA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
BILLING
Authorized Official Telephone Number:
301-942-2474

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 41673501 . This is a "RANDERING NUMBER OF CARE FIRST BLUE CROSS OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 43QMBK . This is a "CARE FIRST INDIVIDUAL PLAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 488178 . This is a "NCPP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 299996 . This is a "ANTHEMHEALTH KEEPER VA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 796421800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0100352 . This is a "AMERICHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 011496600 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 12070001 . This is a "CARE FIRST BCBS OF DC REGION (GHMSI, BLUE CHOICE, BLUE PREFERRED, FEDERAL PLAN)" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 110005885 . This is a "RAILROAD MEDICARE PALMETTO GBA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 299998 . This is a "ANTHEM HEALTHKEEPER BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 3165925 . This is a "ACCUPUNTURE SPECIALIST (ALLIANCE, OPTIMUM CHOICE, MAMSI, M.D.I.PA)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1383592 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 8165925 . This is a "OPTIMUM CHOICE,MAMSI, M.D. IPA (PRIMARY PHYSICIAN)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0004053128 . This is a "AETNA HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0506452 . This is a "AETNA PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 43QMBK . This is a "CARE FIRST BCBS (NASCO)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 76630 . This is a "AMERIGROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2165925 . This is a "ALLIANCE (PRIMARY PHYSICIAN)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0101397 . This is a "EVERCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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